CASE STUDY #2

Sarah is a 42-year-old married woman who has a long history of depressive

episodes.  Across the years she has been variable diagnoses as having major
depression, borderline personality disorder, and most recently, a question of
bipolar disorder.  Review of symptoms indicates that she indeed has had
multiple episodes of depression beginning in her late teens. When asked about
how she feels when she’s not depressed she initially said “fine”. With further
questioning, she revealed that sometimes she had elevated interpersonal
conflict, hyper-sexuality, and less need for sleep and abused alcohol. These
episodes have occurred several times over the years. This led to the provisional
borderline diagnosis, but in the context of her full history, other diagnoses are
being considered.  Sarah notes that she is not currently in a relationship and that
she feels alienated from her family. Because of the variety of symptoms Sarah
presents, she has been taking mood stabilizers occasionally for the last year, but
continues to have low level symptoms of depression.  In the past, she has gone
off her medication multiple times, but at present she says she is “tired of being
in trouble all the time” and wants to try individual psychotherapy.

QUESTIONS:
Thoroughly answer all the questions below and when you’re done, submit the answers in the
drop box provided. 25 points. POSTED ON 3/12; DUE ON PLATO BY 3/19 @11:59PM

1. List all symptoms you notice in this case. Are there any other symptoms you’d ask
about?

Alcohol Use, Depression, Elevated Mood, Impulsivity, Mania/Hypomania, Mood Cycles,

Risky Behaviors

2. What diagnoses are you considering for this case? List the diagnoses and explain why
you’re considering them. Take a look at your text or look at DSM 5 info on line to
explore those diagnoses. Your thinking here is what’s most important.

Bipolar Disorder , Sarah experiences both the lows of depression and the highs of mania.

3. What are some of the treatments you might recommend for this client? Make a list
and explain each and why you’d recommend them.
Lithum and mood stabilizers – 60% of patients with mania improved on these medications.
Psychotherapy often helps the drugs.